scholarly journals pSynGAP1 disturbance-mediated hippocampal oscillation network impairment might contribute to long-term neurobehavioral abnormities in sepsis survivors

Aging ◽  
2020 ◽  
Author(s):  
Yong Wang ◽  
Hua Wei ◽  
Jianhua Tong ◽  
Muhuo Ji ◽  
Jianjun Yang
Keyword(s):  
Oscillation Network ◽  
Sepsis Survivors

Abstract 13315: Long-term Risk of Cardiovascular Events Following Hospitalization for Sepsis: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Leah B Kosyakovsky ◽  
Federico Angriman ◽  
Emma Katz ◽  
Neill Adhikari ◽  
Lucas C Godoy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cumulative Incidence ◽  
Meta Analysis ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Significant Difference ◽  
Sepsis Survivors ◽  
Risk Ratios

Introduction: Sepsis results in dysregulated inflammation, coagulation, and metabolism, which may contribute to increased cardiovascular disease (CVD) risk. We conducted a systematic review and meta-analysis to determine the association between sepsis and subsequent long-term CVD events. Methods: MEDLINE, Embase, and the Cochrane Controlled Trials Register and Database of Systematic Reviews were searched from inception to May 2020 to identify observational studies of adult sepsis survivors (defined by diagnostic codes or consensus definitions) measuring long-term CV outcomes. The primary outcome was a composite of myocardial infarction, CV death, and stroke. Random-effects models estimated the pooled cumulative incidence and adjusted hazard ratios of CV events relative to hospital or population controls. Odds ratios were included as risk ratios assuming <10% incidence in non-septic controls, and risk ratios were taken as hazard ratios (HR) assuming no censoring. Outcomes were analyzed at maximum follow-up (primary analysis) and stratified by time (<1 year, 1-2 years, and >2 years) since sepsis. Results: Of 11,235 abstracts screened, 25 studies (22 cohort studies, 2 case-crossover studies, and 1 case-control) involving 1,949,793 sepsis survivors were included. The pooled cumulative incidence of CVD events was 9% (95% CI; 5-14%). Sepsis was associated with an increased risk (HR 1.59, 95% CI 1.37-1.86) of CVD events at maximum follow-up ( Figure ); between-study heterogeneity was substantial (I 2 =97.3%). There was no significant difference when comparing studies using population and hospital controls. Significantly elevated risk was observed up to 5 years following sepsis. Conclusions: Sepsis survivors experience an approximately 50% increased risk of CVD events, which may persist for years following the index episode. These results highlight a potential unmet need for early cardiac risk stratification and optimization in sepsis survivors.

scholarly journals Targeting the Blood-Brain Barrier to Prevent Sepsis-Associated Cognitive Impairment

2019 ◽  
Vol 11 ◽  
pp. 117957351984065 ◽  
Author(s):  
Divine C Nwafor ◽  
Allison L Brichacek ◽  
Afroz S Mohammad ◽  
Jessica Griffith ◽  
Brandon P Lucke-Wold ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Blood Brain Barrier ◽  
Immune Cell ◽  
The United States ◽  
Brain Barrier ◽  
Blood Brain ◽  
Systemic Inflammatory Disease ◽  
Sepsis Survivors ◽  
The Brain

Sepsis is a systemic inflammatory disease resulting from an infection. This disorder affects 750 000 people annually in the United States and has a 62% rehospitalization rate. Septic symptoms range from typical flu-like symptoms (eg, headache, fever) to a multifactorial syndrome known as sepsis-associated encephalopathy (SAE). Patients with SAE exhibit an acute altered mental status and often have higher mortality and morbidity. In addition, many sepsis survivors are also burdened with long-term cognitive impairment. The mechanisms through which sepsis initiates SAE and promotes long-term cognitive impairment in septic survivors are poorly understood. Due to its unique role as an interface between the brain and the periphery, numerous studies support a regulatory role for the blood-brain barrier (BBB) in the progression of acute and chronic brain dysfunction. In this review, we discuss the current body of literature which supports the BBB as a nexus which integrates signals from the brain and the periphery in sepsis. We highlight key insights on the mechanisms that contribute to the BBB’s role in sepsis which include neuroinflammation, increased barrier permeability, immune cell infiltration, mitochondrial dysfunction, and a potential barrier role for tissue non-specific alkaline phosphatase (TNAP). Finally, we address current drug treatments (eg, antimicrobials and intravenous immunoglobulins) for sepsis and their potential outcomes on brain function. A comprehensive understanding of these mechanisms may enable clinicians to target specific aspects of BBB function as a therapeutic tool to limit long-term cognitive impairment in sepsis survivors.

scholarly journals Older Sepsis Survivors Suffer Persistent Disability Burden and Poor Long‐Term Survival

2020 ◽  
Vol 68 (9) ◽  
pp. 1962-1969 ◽  
Author(s):  
Robert T. Mankowski ◽  
Stephen D. Anton ◽  
Gabriela L. Ghita ◽  
Babette Brumback ◽  
Michael C. Cox ◽  
...  
Keyword(s):  
Term Survival ◽  
Long Term Survival ◽  
Sepsis Survivors ◽  
Persistent Disability

scholarly journals Kidney Damage After Sepsis: A Long-term Follow-up. An Experimental Study.

2021 ◽  
Author(s):  
Ana Maria Alvim Liberatore ◽  
Giovana C. Obara ◽  
Rodrigo Barbosa de Souza ◽  
Luara L. Cassiano ◽  
Ivan Hong Jun Koh
Keyword(s):  
Kidney Injury ◽  
Control Group ◽  
E Coli ◽  
Renal Histology ◽  
Long Term Follow Up ◽  
The Face ◽  
Sepsis Survivors ◽  
Long Term Impact

Abstract Background: Acute kidney injury (AKI) in sepsis is a common event. This study aims to evaluate the long-term impact of sepsis on renal hemodynamics and morphology. Methods: Wistar rats underwent sepsis and survivors (n = 24) were followed for up to six months, monitoring macro, regional and micro hemodynamics of the kidney, serum creatinine, and renal histology. The naive animals were used as the control group (n= 6), and sepsis was induced by E. coli e.v. inoculation. Surviving animals were monitored for up to six months. Results: Overall, the findings show that sepsis survivors have long-term hemodynamic and morphological compromise, as well as a progressive worsening of renal functional unit components over time. Even after six months of recovery from sepsis, severe renal hypoxia, chronic inflammation, evidence of increased vascular resistance, and renal fibrosis were observed in surviving animals. These alterations were present in animals with a healthy appearance and normal MAP. Conclusion: Those findings may represent a state of severely impaired physiology and be a contributing factor to the higher susceptibility to renal failure in the face of a new infectious challenge or to other pathological stimuli in the post-sepsis periods.

scholarly journals Prophylactic Therapy with Human Amniotic Fluid Stem Cells Improves Long-Term Cognitive Impairment in Rat Neonatal Sepsis Survivors

2020 ◽  
Vol 21 (24) ◽  
pp. 9590
Author(s):  
Yushi Abe ◽  
Daigo Ochiai ◽  
Yu Sato ◽  
Seiji Kanzaki ◽  
Satoru Ikenoue ◽  
...  
Keyword(s):  
Stem Cells ◽  
Cognitive Impairment ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Multiple Organ ◽  
Prophylactic Therapy ◽  
Mortality And Morbidity ◽  
Neurological Outcomes ◽  
Sepsis Survivors

A systemic inflammatory response induces multiple organ dysfunction and results in poor long-term neurological outcomes in neonatal sepsis. However, there is no effective therapy for treating or preventing neonatal sepsis besides antibiotics and supportive care. Therefore, a novel strategy to improve neonatal sepsis-related morbidity and mortality is desirable. Recently, we reported that prophylactic therapy with human amniotic stem cells (hAFSCs) improved survival in a rat model of lipopolysaccharide (LPS)-induced neonatal sepsis through immunomodulation. Besides improving the mortality, increasing survival without major morbidities is an important goal of neonatal intensive care for neonatal sepsis. This study investigated long-term neurological outcomes in neonatal sepsis survivors treated with hAFSCs using the LPS-induced neonatal sepsis model in rats. We found that prophylactic therapy with hAFSCs improved spatial awareness and memory-based behavior in neonatal sepsis survivors at adolescence in rats. The treatment suppressed acute reactive gliosis and subsequently reduced astrogliosis in the hippocampal region over a long period of assessment. To the best of our knowledge, this is the first report that proves the concept that hAFSC treatment improves cognitive impairment in neonatal sepsis survivors. We demonstrate the efficacy of hAFSC therapy in improving the mortality and morbidity associated with neonatal sepsis.

The Obesity Paradox in Sepsis: A Theoretical Framework

2020 ◽  
Vol 22 (2) ◽  
pp. 287-294 ◽  
Author(s):  
Jamie Robinson ◽  
Theresa Swift-Scanlan ◽  
Jeanne Salyer ◽  
Terry Jones
Keyword(s):  
Host Response ◽  
Severe Infection ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Healthy Weight ◽  
Life Threatening ◽  
Sepsis Survival ◽  
Hospital Stays ◽  
Sepsis Survivors

Sepsis is a life-threatening syndrome that occurs in response to a severe infection. In recent years, the understanding of the pathobiology of sepsis has been refined, with research describing an altered host response as the underlying cause. Survivors of sepsis often have long hospital stays and suffer from subsequent frailty and long-term health consequences. Predicting attributes of sepsis survivors remains challenging; however, an obesity paradox exists, wherein obese individuals survive sepsis at higher rates than their normal-weight counterparts. We present a model that describes the relationships between sepsis and obesity, focusing on inflammation as a shared pathway for dysregulation in obese and healthy-weight adults. Understanding the interaction of these complex variables is an important first step toward developing interventions and treatments to augment sepsis survival.

Depression and Long-Term Survival Among South Korean Sepsis Survivors

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Tak Kyu Oh ◽  
Hye Youn Park ◽  
In-Ae Song
Keyword(s):  
Term Survival ◽  
Long Term Survival ◽  
South Korean ◽  
Sepsis Survivors
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